Nausea & Vomiting DDx

Nausea & Vomiting – Differential Diagnosis

Common causes

• Infections
  • Gastroenteritis
  • URTI
  • Labyrinthitis
  • UTI
• Gastritis
• Peptic ulcer disease
• Migraine
• Eating disorder
• Psychogenic

Must Not Miss

• ‘Acute abdomen’
  • Appendicitis
  • Intestinal obstruction
  • Pancreatitis
  • Cholecystitis
  • Mesenteric ischaemia
• Raised Intracranial Pressure
• Malignancy
  • Brain tumour
  • Pancreatic Cancer
  • Gastric Cancer
• ‘Silent’ Myocardial Infarction
• Diabetic ketoacidosis
• Acute Glaucoma

Easily missed

• Medication
• Early Pregnancy
• Renal failure
• Hypercalcaemia
• Addison’s disease
• Diabetic Gastroparesis

Red flags

• Severe vomiting
• Dehydration
• Haematemesis
• Petechial rash and fever (meningitis)
• Confusion
• Systemic symptoms (weight loss, sweats, fever)

Investigations to consider

• FBC, CRP/ESR
• U&Es, LFTs, Bone profile,
• Serum glucose,
• Serum amylase
• Urinalysis/ culture
• Pregnancy test
• Toxicology screen
• ECG
• AXR
• USS
• OGD
• CT scan (abdomen, pelvis)
• CT/MRI scan (Head)